title: Emergency Medicine in Guyana: Lessons from Developing the Country's First Degree-conferring Residency Program.
abstract: BACKGROUND
  Academic departments of emergency medicine are becoming increasingly involved in assisting with the development of long-term emergency medicine training programs in low and middle-income countries. This article presents our 10-year experience working with local partners to improve emergency medical care education in Guyana.
  
  
  METHODS
  The Vanderbilt Department of Emergency Medicine has collaborated with the Georgetown Public Hospital Corporation on the development of Emergency Medicine skills followed by the implementation of an emergency medicine residency training program. Residency development included a needs assessment, proposed curriculum, internal and external partnerships, University of Guyana and Ministry of Health approval, and funding.
  
  
  RESULTS
  In our experience, we have found that our successful program initiation was due in large part to the pre-existing interest of several local partners and followed by long-term involvement within the country. As a newer specialty without significant local expertise, resident educational needs mandated a locally present full time EM trained attending to serve as the program director. Both external and internal funding was required to achieve this goal. Local educational efforts were best supplemented by robust distance learning. The program was developed to conform to local academic standards and to train the residents to the level of consultant physicians. Despite the best preparations, future challenges remain.
  
  
  CONCLUSIONS
  While every program has unique challenges, it is likely many of the issues we have faced are generalizable to other settings and will be useful to other programs considering or currently conducting this type of collaborative project.
authors.affiliation: Vanderbilt University, Department of Emergency Medicine, Nashville, Tennessee.
authors.forename: Nicolas P
authors.initials: NP
authors.lastname: Forget
authors.forename: John Paul
authors.initials: JP
authors.lastname: Rohde
authors.forename: Navindranauth
authors.initials: N
authors.lastname: Rambaran
authors.forename: Madan
authors.initials: M
authors.lastname: Rambaran
authors.forename: Seth W
authors.initials: SW
authors.lastname: Wright